NR 293 Final Study Guide
Analgesics
Medications that relieve pain without causing loss of consciousness
“Painkillers”
Opioid analgesics
Adjuvant analgesic
Pain Threshold
Level of stimulus needed to produce the perception of pain
A measure of the physiologic response of the nervous system
Pain Tolerance
The amount of pain a person can endure without it interfering with normal function
Varies from person to person
Subjective response to pain, not a physiologic function
Varies by attitude, environment, culture, ethnicity
Pain by Onset and Duration
Acute pain
Sudden onset
Usually subsides once treated
Chronic pain
Persistent or recurring
Lasts 3 to 6 months
Pain Transmission
1
, Tissue injury causes the release of the following:
BradykininHistaminePotassiumProstaglandinsSerotonin
These substances stimulate nerve endings, starting the pain process.
Rubbing a painful area with massage or liniment stimulates large sensory fibers
Result
Closes gate
Reduces pain sensation
Adjuvant Drugs
Assist primary drugs in relieving pain
NSAIDs
Antidepressants
Anticonvulsants
Corticosteroids
Example: adjuvant drugs for neuropathic pain
Amitriptyline (antidepressant)
Gabapentin or pregabalin (anticonvulsants)
World health organization 3-Step Analgesic Ladder
Step 1: non-opioids (with or without adjuvant medications) after the pain has been
identified and assessed. If pain persists or increases, treatment moves to
Step 2: opioids with or without non-opioids and with or without adjuvants. If pain
persists or increases, management then rises to
Step 3: opioids indicated for moderate to severe pain, administered with or without non-
opioids or adjuvant medications. (this should be the very last)
2
Analgesics
Medications that relieve pain without causing loss of consciousness
“Painkillers”
Opioid analgesics
Adjuvant analgesic
Pain Threshold
Level of stimulus needed to produce the perception of pain
A measure of the physiologic response of the nervous system
Pain Tolerance
The amount of pain a person can endure without it interfering with normal function
Varies from person to person
Subjective response to pain, not a physiologic function
Varies by attitude, environment, culture, ethnicity
Pain by Onset and Duration
Acute pain
Sudden onset
Usually subsides once treated
Chronic pain
Persistent or recurring
Lasts 3 to 6 months
Pain Transmission
1
, Tissue injury causes the release of the following:
BradykininHistaminePotassiumProstaglandinsSerotonin
These substances stimulate nerve endings, starting the pain process.
Rubbing a painful area with massage or liniment stimulates large sensory fibers
Result
Closes gate
Reduces pain sensation
Adjuvant Drugs
Assist primary drugs in relieving pain
NSAIDs
Antidepressants
Anticonvulsants
Corticosteroids
Example: adjuvant drugs for neuropathic pain
Amitriptyline (antidepressant)
Gabapentin or pregabalin (anticonvulsants)
World health organization 3-Step Analgesic Ladder
Step 1: non-opioids (with or without adjuvant medications) after the pain has been
identified and assessed. If pain persists or increases, treatment moves to
Step 2: opioids with or without non-opioids and with or without adjuvants. If pain
persists or increases, management then rises to
Step 3: opioids indicated for moderate to severe pain, administered with or without non-
opioids or adjuvant medications. (this should be the very last)
2
